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The deep inspiration breath hold technique using Abches reduces cardiac dose in patients undergoing left-sided breast irradiation

 Ha Yoon Lee  ;  Jee Suk Chang  ;  Ik Jae Lee  ;  Kwangwoo Park  ;  Yong Bae Kim  ;  Chang Ok Suh  ;  Jun Won Kim  ;  Ki Chang Keum 
 RADIATION ONCOLOGY JOURNAL, Vol.31(4) : 217-224, 2013 
Journal Title
Issue Date
Abches ; Cardiac toxicity ; Deep inspiration breath hold
PURPOSE: We explored whether the deep inspiration breath hold (DIBH) technique using Abches during left-sided breast irradiation was effective for minimizing the amount of radiation to the heart and lung compared to free breathing (FB).
MATERIALS AND METHODS: Between February and July 2012, a total of 25 patients with left-sided breast cancer underwent two computed tomography scans each with the DIBH using Abches and using FB after breast-conserving surgery. The scans were retrospectively replanned using standardized criteria for the purpose of this study. The DIBH plans for each patient were compared with FB plans using dosimetric parameters.
RESULTS: All patients were successfully treated with the DIBH technique using Abches. Significant differences were found between the DIBH and FB plans for mean heart dose (2.52 vs. 4.53 Gy), heart V30 (16.48 vs. 45.13 cm(3)), V20 (21.35 vs. 54.55 cm(3)), mean left anterior descending coronary artery (LAD) dose (16.01 vs. 26.26 Gy, all p < 0.001), and maximal dose to 0.2 cm(3) of the LAD (41.65 vs. 47.27 Gy, p = 0.017). The mean left lung dose (7.53 vs. 8.03 Gy, p = 0.073) and lung V20 (14.63% vs. 15.72%, p = 0.060) of DIBH using Abches were not different significantly compared with FB.
CONCLUSION: We report that the use of a DIBH technique using Abches in breathing adapted radiotherapy for left-sided breast cancer is easily feasible in daily practice and significantly reduces the radiation doses to the heart and LAD, therefore potentially reducing cardiac risk.
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1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Keum, Ki Chang(금기창) ORCID logo https://orcid.org/0000-0003-4123-7998
Kim, Yong Bae(김용배) ORCID logo https://orcid.org/0000-0001-7573-6862
Kim, Jun Won(김준원) ORCID logo https://orcid.org/0000-0003-1358-364X
Park, Kwang Woo(박광우) ORCID logo https://orcid.org/0000-0002-9843-7985
Suh, Chang Ok(서창옥)
Lee, Ik Jae(이익재) ORCID logo https://orcid.org/0000-0001-7165-3373
Chang, Jee Suk(장지석) ORCID logo https://orcid.org/0000-0001-7685-3382
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